Js. Lacroix et Bl. Mosimann, ATTENUATION OF ALLERGEN-EVOKED NASAL RESPONSES BY LOCAL PRETREATMENT WITH EXOGENOUS NEUROPEPTIDE-Y IN ATOPIC PATIENTS, Journal of allergy and clinical immunology, 98(3), 1996, pp. 611-616
Background: Nasal obstruction and rhinorrhea present in allergic rhini
tis are at least partly influenced by neuropeptides released from sens
ory, parasympathetic, and sympathetic nerves. Neuropeptide Y (NPY) is
co-localized with norepinephrine in sympathetic perivascular nerves. N
PY is released with norepinephrine on sympathetic nerve stimulation an
d produces long-lasting vasoconstriction of the nasal vascular bed. In
addition to vasoconstriction, there is evidence to suggest that NPY m
odulates the release of transmitters originating from parasympathetic
and sensory nerves by acting on prejunctional receptors. Putative ther
apeutic application of NPY in rhinitis has been recently suggested bec
ause intranasal administration of exogenous NPY in human beings reduce
s nasal airway resistance and vascular permeability without affecting
submucosal gland secretion. Objective: The aim of this study was to de
termine whether intranasal pretreatment with exogenous NPY could influ
ence the functional responses to subsequent allergen challenge. Method
s: A randomized double-blind, three-way, crossover, placebo-controlled
study was performed in 13 patients with allergic rhinitis. Pretreatme
nts with NPY (20 nmol), oxymetazoline hydrochloride (20 nmol), or sali
ne solution (NaCl 0.9%) were administered in one nostril 5 minutes bef
ore nasal challenge with grass pollen allergen (10,000 standardized qu
ality units). The number of sneezes and the subjective evaluation of n
asal itching, obstruction, and rhinorrhea were recorded. Nasal airway
resistance was measured by anterior rhinomanometry, and nasal secretio
ns were weighed. Mean arterial pressure and heart rate were recorded b
y noninvasive methods. Results: The number of sneezes, nasal itching,
and subjective rhinorrhea evoked by the allergen were similar after th
e three pretreatments. Subjective and objective increases in nasal air
way resistance and mucus production induced by the allergen were signi
ficantly (p < 0.01) reduced after NPY pretreatment when compared with
saline solution or oxymetazoline pretreatment. Mean arterial pressure
and heart rate were not changed. Conclusions: Local pretreatment with
exogenous NPY reduces nasal obstruction and mucus secretion evoked by
allergen challenge in allergic patients without modification of local
itching and number of sneezes.